Healthcare Provider Details

I. General information

NPI: 1477160992
Provider Name (Legal Business Name): SARI HELEN KRASSIN BS, RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 09/29/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 AREA DENTAL CLINIC, BUILDING 13128
CAMP PENDLETON CA
92055-5221
US

IV. Provider business mailing address

PO BOX 555221
CAMP PENDLETON CA
92055-5221
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-5879
  • Fax:
Mailing address:
  • Phone: 310-525-6383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH24329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: